|
0100T
|
HCPCS
|
Prosth Retina Receive&Gen
|
2
|
1
|
—
|
—
|
$293,677.86
|
$293,677.86
|
$293,677.86
|
2026-04-01
|
|
0956T
|
HCPCS
|
Prt Crn Ch Cr&tun Elt S-sclp
|
2
|
1
|
—
|
—
|
$72,104.23
|
$72,104.23
|
$72,104.23
|
2026-04-01
|
|
0960T
|
HCPCS
|
Rpl S-sclp Eltr Ra Rcvr&tlmt
|
2
|
1
|
—
|
—
|
$72,104.23
|
$72,104.23
|
$72,104.23
|
2026-04-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
2
|
1
|
—
|
—
|
$216,736.84
|
$216,736.84
|
$216,736.84
|
2026-04-01
|
|
11
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
4
|
2
|
—
|
—
|
$97,885.53
|
$134,658.59
|
$116,272.06
|
2026-04-01
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
1
|
—
|
—
|
$87,027.75
|
$87,027.75
|
$87,027.75
|
2026-04-01
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
1
|
—
|
—
|
$164,297.31
|
$164,297.31
|
$164,297.31
|
2026-04-01
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
1
|
—
|
—
|
$333,784.44
|
$333,784.44
|
$333,784.44
|
2026-04-01
|
|
12
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
4
|
2
|
—
|
—
|
$97,885.53
|
$151,665.09
|
$124,775.31
|
2026-04-01
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
4
|
2
|
—
|
—
|
$96,734.09
|
$113,844.76
|
$105,289.42
|
2026-04-01
|
|
1214
|
APR_DRG
|
Other Respiratory And Chest Procedures
|
4
|
2
|
—
|
—
|
$93,083.27
|
$96,198.86
|
$94,641.07
|
2026-04-01
|
|
13
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
4
|
2
|
—
|
—
|
$132,876.75
|
$180,959.27
|
$156,918.01
|
2026-04-01
|
|
1303
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
4
|
2
|
—
|
—
|
$67,965.43
|
$83,405.77
|
$75,685.60
|
2026-04-01
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
4
|
2
|
—
|
—
|
$96,448.21
|
$108,037.83
|
$102,243.02
|
2026-04-01
|
|
14
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
4
|
2
|
—
|
—
|
$278,020.76
|
$313,007.69
|
$295,514.22
|
2026-04-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
1
|
—
|
—
|
$92,946.44
|
$92,946.44
|
$92,946.44
|
2026-04-01
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
4
|
2
|
—
|
—
|
$75,917.55
|
$115,249.07
|
$95,583.31
|
2026-04-01
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
4
|
2
|
—
|
—
|
$157,929.02
|
$214,695.33
|
$186,312.17
|
2026-04-01
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
2
|
—
|
—
|
$63,755.11
|
$296,491.82
|
$180,123.47
|
2026-04-01
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
2
|
—
|
—
|
$97,318.54
|
$312,098.38
|
$204,708.46
|
2026-04-01
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
2
|
—
|
—
|
$156,272.53
|
$388,707.21
|
$272,489.87
|
2026-04-01
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
2
|
—
|
—
|
$366,569.27
|
$507,382.01
|
$436,975.64
|
2026-04-01
|
|
1621
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$54,985.07
|
$93,733.09
|
$74,359.08
|
2026-04-01
|
|
1622
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$71,184.71
|
$109,839.00
|
$90,511.86
|
2026-04-01
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$91,110.27
|
$138,590.21
|
$114,850.24
|
2026-04-01
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$149,047.81
|
$202,346.60
|
$175,697.21
|
2026-04-01
|
|
1632
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$58,764.99
|
$90,717.32
|
$74,741.15
|
2026-04-01
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$72,193.22
|
$114,627.60
|
$93,410.41
|
2026-04-01
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$111,920.45
|
$172,184.54
|
$142,052.49
|
2026-04-01
|
|
1651
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$62,471.85
|
$79,428.36
|
$70,950.10
|
2026-04-01
|
|
1652
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$62,686.25
|
$96,722.69
|
$79,704.47
|
2026-04-01
|
|
1653
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$77,208.75
|
$116,293.58
|
$96,751.17
|
2026-04-01
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$112,390.56
|
$157,458.95
|
$134,924.76
|
2026-04-01
|
|
1663
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$63,778.94
|
$96,685.62
|
$80,232.28
|
2026-04-01
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
4
|
2
|
—
|
—
|
$98,963.92
|
$141,935.25
|
$120,449.58
|
2026-04-01
|
|
1673
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
4
|
2
|
—
|
—
|
$58,464.82
|
$96,467.56
|
$77,466.19
|
2026-04-01
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
4
|
2
|
—
|
—
|
$105,316.72
|
$154,881.48
|
$130,099.10
|
2026-04-01
|
|
1693
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
4
|
2
|
—
|
—
|
$59,007.98
|
$81,659.11
|
$70,333.54
|
2026-04-01
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
4
|
2
|
—
|
—
|
$114,078.82
|
$132,846.51
|
$123,462.67
|
2026-04-01
|
|
1704
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
4
|
2
|
—
|
—
|
$76,432.13
|
$93,674.21
|
$85,053.17
|
2026-04-01
|
|
1714
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
4
|
2
|
—
|
—
|
$74,807.66
|
$94,717.07
|
$84,762.37
|
2026-04-01
|
|
1744
|
APR_DRG
|
Percutaneous Cardiac Intervention With Ami
|
4
|
2
|
—
|
—
|
$60,809.00
|
$79,314.96
|
$70,061.98
|
2026-04-01
|
|
1754
|
APR_DRG
|
Percutaneous Cardiac Intervention Without Ami
|
4
|
2
|
—
|
—
|
$77,991.74
|
$87,640.49
|
$82,816.12
|
2026-04-01
|
|
1764
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
4
|
2
|
—
|
—
|
$56,398.57
|
$107,904.81
|
$82,151.69
|
2026-04-01
|
|
1774
|
APR_DRG
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
4
|
2
|
—
|
—
|
$67,969.30
|
$100,606.12
|
$84,287.71
|
2026-04-01
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
2
|
1
|
—
|
—
|
$105,146.35
|
$105,146.35
|
$105,146.35
|
2026-04-01
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
2
|
1
|
—
|
—
|
$117,887.60
|
$117,887.60
|
$117,887.60
|
2026-04-01
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
2
|
1
|
—
|
—
|
$126,531.50
|
$126,531.50
|
$126,531.50
|
2026-04-01
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
2
|
1
|
—
|
—
|
$171,035.36
|
$171,035.36
|
$171,035.36
|
2026-04-01
|
|
1791
|
APR_DRG
|
Defibrillator Implants
|
2
|
1
|
—
|
—
|
$73,050.10
|
$73,050.10
|
$73,050.10
|
2026-04-01
|
|
1792
|
APR_DRG
|
Defibrillator Implants
|
2
|
1
|
—
|
—
|
$82,784.30
|
$82,784.30
|
$82,784.30
|
2026-04-01
|
|
1793
|
APR_DRG
|
Defibrillator Implants
|
2
|
1
|
—
|
—
|
$101,605.06
|
$101,605.06
|
$101,605.06
|
2026-04-01
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
2
|
1
|
—
|
—
|
$139,346.88
|
$139,346.88
|
$139,346.88
|
2026-04-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
1
|
—
|
—
|
$333,975.78
|
$333,975.78
|
$333,975.78
|
2026-04-01
|
|
1804
|
APR_DRG
|
Other Circulatory System Procedures
|
4
|
2
|
—
|
—
|
$76,536.95
|
$79,044.57
|
$77,790.76
|
2026-04-01
|
|
1813
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
4
|
2
|
—
|
—
|
$64,962.14
|
$70,450.82
|
$67,706.48
|
2026-04-01
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
4
|
2
|
—
|
—
|
$105,083.25
|
$109,839.00
|
$107,461.12
|
2026-04-01
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular Procedures
|
4
|
2
|
—
|
—
|
$93,318.78
|
$99,611.90
|
$96,465.34
|
2026-04-01
|
|
1831
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
1
|
—
|
—
|
$85,599.45
|
$85,599.45
|
$85,599.45
|
2026-04-01
|
|
1832
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
1
|
—
|
—
|
$88,052.63
|
$88,052.63
|
$88,052.63
|
2026-04-01
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
1
|
—
|
—
|
$102,525.27
|
$102,525.27
|
$102,525.27
|
2026-04-01
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
1
|
—
|
—
|
$145,951.92
|
$145,951.92
|
$145,951.92
|
2026-04-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
2
|
1
|
—
|
—
|
$87,640.14
|
$87,640.14
|
$87,640.14
|
2026-04-01
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
4
|
2
|
—
|
—
|
$106,250.58
|
$114,372.47
|
$110,311.52
|
2026-04-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
2
|
1
|
—
|
—
|
$87,539.60
|
$87,539.60
|
$87,539.60
|
2026-04-01
|
|
21
|
APR_DRG
|
Heart And/Or Lung Transplant
|
4
|
2
|
—
|
—
|
$192,173.79
|
$192,627.66
|
$192,400.73
|
2026-04-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
2
|
1
|
—
|
—
|
$84,100.29
|
$84,100.29
|
$84,100.29
|
2026-04-01
|
|
213
|
APR_DRG
|
Open Craniotomy Except Trauma
|
4
|
2
|
—
|
—
|
$68,799.24
|
$79,458.88
|
$74,129.06
|
2026-04-01
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
4
|
2
|
—
|
—
|
$115,007.91
|
$123,971.47
|
$119,489.69
|
2026-04-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
2
|
1
|
—
|
—
|
$77,007.44
|
$77,007.44
|
$77,007.44
|
2026-04-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
2
|
1
|
—
|
—
|
$75,660.18
|
$75,660.18
|
$75,660.18
|
2026-04-01
|
|
22
|
APR_DRG
|
Heart And/Or Lung Transplant
|
4
|
2
|
—
|
—
|
$204,017.00
|
$224,699.93
|
$214,358.46
|
2026-04-01
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
4
|
2
|
—
|
—
|
$112,566.85
|
$117,425.31
|
$114,996.08
|
2026-04-01
|
|
2214
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$104,953.02
|
$104,953.02
|
$104,953.02
|
2026-04-01
|
|
2224
|
APR_DRG
|
Other Stomach, Esophageal And Duodenal Procedures
|
4
|
2
|
—
|
—
|
$86,255.81
|
$87,890.99
|
$87,073.40
|
2026-04-01
|
|
2234
|
APR_DRG
|
Other Small And Large Bowel Procedures
|
4
|
2
|
—
|
—
|
$82,902.05
|
$88,597.74
|
$85,749.90
|
2026-04-01
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
4
|
2
|
—
|
—
|
$85,564.28
|
$94,736.17
|
$90,150.23
|
2026-04-01
|
|
2244
|
APR_DRG
|
Peritoneal Adhesiolysis
|
4
|
2
|
—
|
—
|
$80,512.11
|
$88,440.51
|
$84,476.31
|
2026-04-01
|
|
2274
|
APR_DRG
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
4
|
2
|
—
|
—
|
$81,148.85
|
$83,756.90
|
$82,452.88
|
2026-04-01
|
|
2294
|
APR_DRG
|
Other Digestive System And Abdominal Procedures
|
4
|
2
|
—
|
—
|
$86,214.38
|
$91,905.96
|
$89,060.17
|
2026-04-01
|
|
23
|
APR_DRG
|
Heart And/Or Lung Transplant
|
4
|
2
|
—
|
—
|
$239,322.68
|
$302,785.03
|
$271,053.85
|
2026-04-01
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
2
|
1
|
—
|
—
|
$105,246.66
|
$105,246.66
|
$105,246.66
|
2026-04-01
|
|
2314
|
APR_DRG
|
Major Large Bowel Procedures
|
2
|
1
|
—
|
—
|
$92,603.54
|
$92,603.54
|
$92,603.54
|
2026-04-01
|
|
2324
|
APR_DRG
|
Gastric Fundoplication
|
2
|
1
|
—
|
—
|
$86,460.79
|
$86,460.79
|
$86,460.79
|
2026-04-01
|
|
233
|
APR_DRG
|
Spinal Procedures
|
4
|
2
|
—
|
—
|
$68,235.42
|
$77,236.85
|
$72,736.14
|
2026-04-01
|
|
234
|
APR_DRG
|
Spinal Procedures
|
4
|
2
|
—
|
—
|
$125,694.15
|
$128,359.91
|
$127,027.03
|
2026-04-01
|
|
24
|
APR_DRG
|
Heart And/Or Lung Transplant
|
4
|
2
|
—
|
—
|
$489,638.47
|
$554,176.98
|
$521,907.72
|
2026-04-01
|
|
244
|
APR_DRG
|
Open Extracranial Vascular Procedures
|
4
|
2
|
—
|
—
|
$82,897.69
|
$107,895.96
|
$95,396.83
|
2026-04-01
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
4
|
2
|
—
|
—
|
$117,947.67
|
$122,394.90
|
$120,171.29
|
2026-04-01
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
4
|
2
|
—
|
—
|
$97,525.01
|
$107,582.08
|
$102,553.54
|
2026-04-01
|
|
2624
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$96,143.28
|
$96,143.28
|
$96,143.28
|
2026-04-01
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
4
|
2
|
—
|
—
|
$95,307.48
|
$99,673.84
|
$97,490.66
|
2026-04-01
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
4
|
2
|
—
|
—
|
$95,560.43
|
$97,747.36
|
$96,653.89
|
2026-04-01
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
2
|
1
|
—
|
—
|
$109,274.23
|
$109,274.23
|
$109,274.23
|
2026-04-01
|
|
294
|
APR_DRG
|
Other Percutaneous Intracranial Procedures
|
2
|
1
|
—
|
—
|
$88,591.24
|
$88,591.24
|
$88,591.24
|
2026-04-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
2
|
1
|
—
|
—
|
$164,155.70
|
$164,155.70
|
$164,155.70
|
2026-04-01
|
|
3014
|
APR_DRG
|
Hip Joint Replacement
|
2
|
1
|
—
|
—
|
$96,144.86
|
$96,144.86
|
$96,144.86
|
2026-04-01
|
|
3024
|
APR_DRG
|
Knee Joint Replacement
|
2
|
1
|
—
|
—
|
$86,442.55
|
$86,442.55
|
$86,442.55
|
2026-04-01
|
|
303
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
2
|
1
|
—
|
—
|
$73,263.80
|
$73,263.80
|
$73,263.80
|
2026-04-01
|
|
3031
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
4
|
2
|
—
|
—
|
$70,195.26
|
$88,602.14
|
$79,398.70
|
2026-04-01
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
4
|
2
|
—
|
—
|
$83,990.37
|
$106,419.82
|
$95,205.10
|
2026-04-01
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
4
|
2
|
—
|
—
|
$110,983.42
|
$146,473.08
|
$128,728.25
|
2026-04-01
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
4
|
2
|
—
|
—
|
$173,026.45
|
$193,449.75
|
$183,238.10
|
2026-04-01
|
|
304
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
2
|
1
|
—
|
—
|
$96,727.05
|
$96,727.05
|
$96,727.05
|
2026-04-01
|
|
3043
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
4
|
2
|
—
|
—
|
$84,612.94
|
$100,344.67
|
$92,478.80
|
2026-04-01
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
4
|
2
|
—
|
—
|
$145,831.70
|
$148,481.42
|
$147,156.56
|
2026-04-01
|
|
3054
|
APR_DRG
|
Amputation Of Lower Limb Except Toes
|
4
|
2
|
—
|
—
|
$83,830.99
|
$100,085.19
|
$91,958.09
|
2026-04-01
|
|
3084
|
APR_DRG
|
Hip And Femur Fracture Repair
|
4
|
2
|
—
|
—
|
$65,544.47
|
$91,620.08
|
$78,582.27
|
2026-04-01
|
|
3094
|
APR_DRG
|
Other Significant Hip And Femur Surgery
|
4
|
2
|
—
|
—
|
$87,889.08
|
$91,243.68
|
$89,566.38
|
2026-04-01
|
|
31
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$105,227.78
|
$105,227.78
|
$105,227.78
|
2026-04-01
|
|
3104
|
APR_DRG
|
Intervertebral Disc Excision And Decompression
|
4
|
2
|
—
|
—
|
$76,739.68
|
$108,667.82
|
$92,703.75
|
2026-04-01
|
|
3123
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
4
|
2
|
—
|
—
|
$65,034.21
|
$71,908.93
|
$68,471.57
|
2026-04-01
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
4
|
2
|
—
|
—
|
$131,891.41
|
$142,974.53
|
$137,432.97
|
2026-04-01
|
|
3134
|
APR_DRG
|
Knee And Lower Leg Procedures Except Foot
|
4
|
2
|
—
|
—
|
$83,473.37
|
$102,777.19
|
$93,125.28
|
2026-04-01
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
4
|
2
|
—
|
—
|
$79,458.88
|
$81,528.66
|
$80,493.77
|
2026-04-01
|
|
3174
|
APR_DRG
|
Tendon, Muscle And Other Soft Tissue Procedures
|
4
|
2
|
—
|
—
|
$73,560.36
|
$100,342.48
|
$86,951.42
|
2026-04-01
|
|
32
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$123,253.85
|
$123,253.85
|
$123,253.85
|
2026-04-01
|
|
3204
|
APR_DRG
|
Other Musculoskeletal System And Connective Tissue Procedures
|
4
|
2
|
—
|
—
|
$77,563.94
|
$79,467.18
|
$78,515.56
|
2026-04-01
|
|
3214
|
APR_DRG
|
Decompression
|
4
|
2
|
—
|
—
|
$97,437.93
|
$112,193.62
|
$104,815.77
|
2026-04-01
|
|
3234
|
APR_DRG
|
Non-elective Or Complex Hip Joint Replacement
|
2
|
1
|
—
|
—
|
$74,456.59
|
$74,456.59
|
$74,456.59
|
2026-04-01
|
|
3244
|
APR_DRG
|
Elective Hip Joint Replacement
|
2
|
1
|
—
|
—
|
$74,526.37
|
$74,526.37
|
$74,526.37
|
2026-04-01
|
|
3253
|
APR_DRG
|
Non-elective Or Complex Knee Joint Replacement
|
2
|
1
|
—
|
—
|
$68,196.08
|
$68,196.08
|
$68,196.08
|
2026-04-01
|
|
3254
|
APR_DRG
|
Non-elective Or Complex Knee Joint Replacement
|
2
|
1
|
—
|
—
|
$94,932.42
|
$94,932.42
|
$94,932.42
|
2026-04-01
|
|
33
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$187,774.47
|
$187,774.47
|
$187,774.47
|
2026-04-01
|
|
34
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$355,920.38
|
$355,920.38
|
$355,920.38
|
2026-04-01
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
4
|
2
|
—
|
—
|
$111,694.69
|
$152,475.14
|
$132,084.92
|
2026-04-01
|
|
3644
|
APR_DRG
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
4
|
2
|
—
|
—
|
$63,052.05
|
$84,322.30
|
$73,687.18
|
2026-04-01
|
|
3814
|
APR_DRG
|
Major Skin Disorders
|
4
|
2
|
—
|
—
|
$51,501.41
|
$93,748.27
|
$72,624.84
|
2026-04-01
|
|
38240
|
HCPCS
|
Transplt Allo Hct/donor
|
2
|
1
|
—
|
—
|
$72,972.00
|
$72,972.00
|
$72,972.00
|
2026-04-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
2
|
1
|
—
|
—
|
$107,126.73
|
$107,126.73
|
$107,126.73
|
2026-04-01
|
|
4014
|
APR_DRG
|
Adrenal Procedures
|
4
|
2
|
—
|
—
|
$103,074.78
|
$110,978.65
|
$107,026.71
|
2026-04-01
|
|
4034
|
APR_DRG
|
Procedures For Obesity
|
4
|
2
|
—
|
—
|
$81,604.59
|
$104,451.15
|
$93,027.87
|
2026-04-01
|
|
4044
|
APR_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
4
|
2
|
—
|
—
|
$42,352.53
|
$101,293.23
|
$71,822.88
|
2026-04-01
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
4
|
2
|
—
|
—
|
$94,524.65
|
$133,219.80
|
$113,872.22
|
2026-04-01
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
2
|
—
|
—
|
$99,893.29
|
$114,169.35
|
$107,031.32
|
2026-04-01
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
2
|
—
|
—
|
$114,169.35
|
$149,589.16
|
$131,879.26
|
2026-04-01
|
|
4234
|
APR_DRG
|
Inborn Errors Of Metabolism
|
4
|
2
|
—
|
—
|
$48,431.13
|
$86,371.08
|
$67,401.10
|
2026-04-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
2
|
1
|
—
|
—
|
$85,237.96
|
$85,237.96
|
$85,237.96
|
2026-04-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
2
|
1
|
—
|
—
|
$69,680.25
|
$69,680.25
|
$69,680.25
|
2026-04-01
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
2
|
—
|
—
|
$159,941.27
|
$217,582.45
|
$188,761.86
|
2026-04-01
|
|
434
|
APR_DRG
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
4
|
2
|
—
|
—
|
$65,230.47
|
$93,984.91
|
$79,607.69
|
2026-04-01
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
2
|
—
|
—
|
$287,021.09
|
$317,951.11
|
$302,486.10
|
2026-04-01
|
|
4401
|
APR_DRG
|
Kidney Transplant
|
4
|
2
|
—
|
—
|
$58,858.69
|
$92,836.86
|
$75,847.77
|
2026-04-01
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
4
|
2
|
—
|
—
|
$73,778.24
|
$103,968.83
|
$88,873.54
|
2026-04-01
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
4
|
2
|
—
|
—
|
$90,089.06
|
$121,223.92
|
$105,656.49
|
2026-04-01
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
4
|
2
|
—
|
—
|
$164,920.28
|
$183,907.44
|
$174,413.86
|
2026-04-01
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
4
|
2
|
—
|
—
|
$107,414.73
|
$123,949.67
|
$115,682.20
|
2026-04-01
|
|
4424
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Malignancy
|
4
|
2
|
—
|
—
|
$87,411.53
|
$101,262.04
|
$94,336.79
|
2026-04-01
|
|
4434
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Non-malignancy
|
4
|
2
|
—
|
—
|
$71,033.05
|
$80,486.80
|
$75,759.93
|
2026-04-01
|
|
4444
|
APR_DRG
|
Renal Dialysis Access Device Procedures And Vessel Repair
|
4
|
2
|
—
|
—
|
$73,610.51
|
$98,244.46
|
$85,927.49
|
2026-04-01
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract And Related Procedures
|
4
|
2
|
—
|
—
|
$91,539.41
|
$121,189.19
|
$106,364.30
|
2026-04-01
|
|
4834
|
APR_DRG
|
Penis, Testes And Scrotal Procedures
|
4
|
2
|
—
|
—
|
$67,943.20
|
$71,425.55
|
$69,684.38
|
2026-04-01
|
|
494
|
APR_DRG
|
Bacterial And Tuberculous Infections Of Nervous System
|
4
|
2
|
—
|
—
|
$73,316.13
|
$94,775.84
|
$84,045.99
|
2026-04-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
2
|
1
|
—
|
—
|
$79,741.41
|
$79,741.41
|
$79,741.41
|
2026-04-01
|
|
504
|
APR_DRG
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
4
|
2
|
—
|
—
|
$77,531.23
|
$84,913.11
|
$81,222.17
|
2026-04-01
|
|
51
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
2
|
—
|
—
|
$90,465.46
|
$93,789.79
|
$92,127.62
|
2026-04-01
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
4
|
2
|
—
|
—
|
$101,792.50
|
$105,207.41
|
$103,499.96
|
2026-04-01
|
|
5114
|
APR_DRG
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
4
|
2
|
—
|
—
|
$94,973.85
|
$98,887.68
|
$96,930.76
|
2026-04-01
|
|
5124
|
APR_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
4
|
2
|
—
|
—
|
$84,334.71
|
$119,169.00
|
$101,751.86
|
2026-04-01
|
|
5134
|
APR_DRG
|
Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma
|
4
|
2
|
—
|
—
|
$63,403.13
|
$76,259.01
|
$69,831.07
|
2026-04-01
|
|
5184
|
APR_DRG
|
Other Female Reproductive System And Related Procedures
|
4
|
2
|
—
|
—
|
$77,677.33
|
$94,941.01
|
$86,309.17
|
2026-04-01
|
|
5194
|
APR_DRG
|
Uterine And Adnexa Procedures For Leiomyoma
|
4
|
2
|
—
|
—
|
$75,906.69
|
$96,067.04
|
$85,986.86
|
2026-04-01
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
2
|
—
|
—
|
$92,808.06
|
$112,944.18
|
$102,876.12
|
2026-04-01
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
2
|
—
|
—
|
$146,633.74
|
$154,299.26
|
$150,466.50
|
2026-04-01
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
2
|
—
|
—
|
$209,536.03
|
$219,004.84
|
$214,270.43
|
2026-04-01
|
|
5464
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$68,414.89
|
$68,414.89
|
$68,414.89
|
2026-04-01
|
|
5484
|
APR_DRG
|
Postpartum And Post Abortion Diagnosis With O.r. Procedure
|
2
|
1
|
—
|
—
|
$74,890.53
|
$74,890.53
|
$74,890.53
|
2026-04-01
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
4
|
2
|
—
|
—
|
$227,422.30
|
$326,520.86
|
$276,971.58
|
2026-04-01
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
4
|
2
|
—
|
—
|
$227,422.30
|
$377,839.10
|
$302,630.70
|
2026-04-01
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
4
|
2
|
—
|
—
|
$231,756.50
|
$512,390.85
|
$372,073.67
|
2026-04-01
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
4
|
2
|
—
|
—
|
$407,940.29
|
$646,942.59
|
$527,441.44
|
2026-04-01
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
2
|
—
|
—
|
$220,353.99
|
$306,594.07
|
$263,474.03
|
2026-04-01
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
2
|
—
|
—
|
$306,594.07
|
$334,763.53
|
$320,678.80
|
2026-04-01
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
2
|
—
|
—
|
$341,876.65
|
$400,769.56
|
$371,323.10
|
2026-04-01
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
2
|
—
|
—
|
$400,769.56
|
$530,668.64
|
$465,719.10
|
2026-04-01
|
|
5891
|
APR_DRG
|
Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini…
|
4
|
2
|
—
|
—
|
$103,680.99
|
$192,790.01
|
$148,235.50
|
2026-04-01
|
|
5892
|
APR_DRG
|
Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini…
|
4
|
2
|
—
|
—
|
$86,070.46
|
$192,790.01
|
$139,430.24
|
2026-04-01
|
|
5893
|
APR_DRG
|
Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini…
|
4
|
2
|
—
|
—
|
$68,462.12
|
$69,879.21
|
$69,170.67
|
2026-04-01
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$2,830.42
|
$141,181.45
|
$72,005.93
|
2026-04-01
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$104,189.07
|
$175,049.82
|
$139,619.45
|
2026-04-01
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$187,642.65
|
$195,798.25
|
$191,720.45
|
2026-04-01
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$307,705.81
|
$334,214.02
|
$320,959.92
|
2026-04-01
|
|
5931
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$3,266.54
|
$171,570.07
|
$87,418.30
|
2026-04-01
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$176,401.82
|
$176,958.83
|
$176,680.33
|
2026-04-01
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$216,281.08
|
$222,562.94
|
$219,422.01
|
2026-04-01
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
4
|
2
|
—
|
—
|
$276,916.96
|
$346,096.11
|
$311,506.54
|
2026-04-01
|
|
6022
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
4
|
2
|
—
|
—
|
$149,264.25
|
$150,624.89
|
$149,944.57
|
2026-04-01
|
|
6023
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
4
|
2
|
—
|
—
|
$177,276.47
|
$195,619.45
|
$186,447.96
|
2026-04-01
|
|
6024
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
4
|
2
|
—
|
—
|
$240,161.25
|
$248,082.50
|
$244,121.88
|
2026-04-01
|
|
6032
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
4
|
2
|
—
|
—
|
$66,796.14
|
$109,561.98
|
$88,179.06
|
2026-04-01
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
4
|
2
|
—
|
—
|
$135,382.55
|
$142,596.54
|
$138,989.54
|
2026-04-01
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
4
|
2
|
—
|
—
|
$221,233.08
|
$278,203.13
|
$249,718.10
|
2026-04-01
|
|
6071
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
4
|
2
|
—
|
—
|
$47,510.91
|
$95,946.34
|
$71,728.62
|
2026-04-01
|
|
6072
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
4
|
2
|
—
|
—
|
$114,784.60
|
$118,771.95
|
$116,778.27
|
2026-04-01
|
|
6073
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
4
|
2
|
—
|
—
|
$145,306.01
|
$148,237.19
|
$146,771.60
|
2026-04-01
|
|
6074
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
4
|
2
|
—
|
—
|
$190,549.55
|
$196,072.82
|
$193,311.18
|
2026-04-01
|
|
6082
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
4
|
2
|
—
|
—
|
$84,823.16
|
$90,305.05
|
$87,564.11
|
2026-04-01
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
4
|
2
|
—
|
—
|
$108,372.42
|
$114,902.36
|
$111,637.39
|
2026-04-01
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
4
|
2
|
—
|
—
|
$114,070.88
|
$120,648.24
|
$117,359.56
|
2026-04-01
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
4
|
2
|
—
|
—
|
$57,097.38
|
$78,584.46
|
$67,840.92
|
2026-04-01
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
4
|
2
|
—
|
—
|
$115,670.19
|
$165,444.30
|
$140,557.24
|
2026-04-01
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
4
|
2
|
—
|
—
|
$253,543.42
|
$332,081.39
|
$292,812.41
|
2026-04-01
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
4
|
2
|
—
|
—
|
$80,289.86
|
$132,628.45
|
$106,459.15
|
2026-04-01
|
|
6113
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
4
|
2
|
—
|
—
|
$94,315.31
|
$99,513.44
|
$96,914.38
|
2026-04-01
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
4
|
2
|
—
|
—
|
$130,449.98
|
$144,802.74
|
$137,626.36
|
2026-04-01
|
|
6122
|
APR_DRG
|
Respiratory Condition
|
4
|
2
|
—
|
—
|
$72,264.69
|
$75,411.69
|
$73,838.19
|
2026-04-01
|
|
6123
|
APR_DRG
|
Respiratory Condition
|
4
|
2
|
—
|
—
|
$97,381.23
|
$100,739.53
|
$99,060.38
|
2026-04-01
|
|
6124
|
APR_DRG
|
Respiratory Condition
|
4
|
2
|
—
|
—
|
$134,577.72
|
$138,468.10
|
$136,522.91
|
2026-04-01
|
|
6133
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
4
|
2
|
—
|
—
|
$80,167.57
|
$88,589.06
|
$84,378.32
|
2026-04-01
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
4
|
2
|
—
|
—
|
$82,238.58
|
$135,853.56
|
$109,046.07
|
2026-04-01
|
|
6143
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
4
|
2
|
—
|
—
|
$79,983.34
|
$83,752.48
|
$81,867.91
|
2026-04-01
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
4
|
2
|
—
|
—
|
$79,983.34
|
$109,173.92
|
$94,578.63
|
2026-04-01
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
4
|
2
|
—
|
—
|
$80,289.86
|
$168,728.29
|
$124,509.08
|
2026-04-01
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
4
|
2
|
—
|
—
|
$107,872.13
|
$113,600.54
|
$110,736.33
|
2026-04-01
|
|
6224
|
APR_DRG
|
Respiratory Condition
|
4
|
2
|
—
|
—
|
$82,094.06
|
$89,664.09
|
$85,879.07
|
2026-04-01
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
4
|
2
|
—
|
—
|
$116,164.12
|
$194,365.60
|
$155,264.86
|
2026-04-01
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
4
|
2
|
—
|
—
|
$56,963.97
|
$118,079.49
|
$87,521.73
|
2026-04-01
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
4
|
2
|
—
|
—
|
$94,108.79
|
$186,109.85
|
$140,109.32
|
2026-04-01
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
4
|
2
|
—
|
—
|
$194,228.92
|
$385,179.00
|
$289,703.96
|
2026-04-01
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
4
|
2
|
—
|
—
|
$77,440.63
|
$122,431.97
|
$99,936.30
|
2026-04-01
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
4
|
2
|
—
|
—
|
$166,973.82
|
$318,812.44
|
$242,893.13
|
2026-04-01
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
4
|
2
|
—
|
—
|
$85,030.64
|
$103,251.41
|
$94,141.02
|
2026-04-01
|
|
6344
|
APR_DRG
|
Respiratory Condition
|
4
|
2
|
—
|
—
|
$64,060.05
|
$79,133.97
|
$71,597.01
|
2026-04-01
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
4
|
2
|
—
|
—
|
$121,321.01
|
$276,421.58
|
$198,871.29
|
2026-04-01
|
|
64654
|
HCPCS
|
1st Opn Implt Bat Modulj Sys
|
2
|
1
|
—
|
—
|
$130,051.45
|
$130,051.45
|
$130,051.45
|
2026-04-01
|
|
6504
|
APR_DRG
|
Splenectomy
|
4
|
2
|
—
|
—
|
$90,575.05
|
$92,950.26
|
$91,762.65
|
2026-04-01
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
4
|
2
|
—
|
—
|
$59,905.32
|
$102,422.78
|
$81,164.05
|
2026-04-01
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
4
|
2
|
—
|
—
|
$138,769.02
|
$142,085.14
|
$140,427.08
|
2026-04-01
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
4
|
2
|
—
|
—
|
$118,330.26
|
$142,480.60
|
$130,405.43
|
2026-04-01
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
4
|
2
|
—
|
—
|
$65,053.84
|
$96,290.98
|
$80,672.41
|
2026-04-01
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
4
|
2
|
—
|
—
|
$113,266.91
|
$139,016.73
|
$126,141.82
|
2026-04-01
|
|
6914
|
APR_DRG
|
Lymphoma, Myeloma And Non-acute Leukemia
|
4
|
2
|
—
|
—
|
$66,560.63
|
$100,577.53
|
$83,569.08
|
2026-04-01
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
4
|
2
|
—
|
—
|
$106,600.81
|
$117,317.16
|
$111,958.99
|
2026-04-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
2
|
1
|
—
|
—
|
$100,156.85
|
$100,156.85
|
$100,156.85
|
2026-04-01
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
1
|
—
|
—
|
$131,758.39
|
$131,758.39
|
$131,758.39
|
2026-04-01
|
|
7104
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
4
|
2
|
—
|
—
|
$95,252.97
|
$100,380.59
|
$97,816.78
|
2026-04-01
|
|
7114
|
APR_DRG
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
4
|
2
|
—
|
—
|
$89,853.80
|
$95,862.16
|
$92,857.98
|
2026-04-01
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
1
|
—
|
—
|
$147,973.34
|
$147,973.34
|
$147,973.34
|
2026-04-01
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
1
|
—
|
—
|
$189,173.59
|
$189,173.59
|
$189,173.59
|
2026-04-01
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
1
|
—
|
—
|
$320,999.58
|
$320,999.58
|
$320,999.58
|
2026-04-01
|
|
7404
|
APR_DRG
|
Mental Illness Diagnosis With O.r. Procedure
|
4
|
2
|
—
|
—
|
$48,058.93
|
$120,827.05
|
$84,442.99
|
2026-04-01
|
|
7504
|
APR_DRG
|
Schizophrenia
|
4
|
2
|
—
|
—
|
$46,135.62
|
$115,440.96
|
$80,788.29
|
2026-04-01
|
|
7524
|
APR_DRG
|
Disorders Of Personality And Impulse Control
|
4
|
2
|
—
|
—
|
$15,059.31
|
$172,393.87
|
$93,726.59
|
2026-04-01
|
|
7594
|
APR_DRG
|
Eating Disorders
|
4
|
2
|
—
|
—
|
$33,599.96
|
$245,997.85
|
$139,798.90
|
2026-04-01
|
|
7754
|
APR_DRG
|
Alcohol Abuse And Dependence
|
4
|
2
|
—
|
—
|
$62,246.32
|
$90,156.91
|
$76,201.62
|
2026-04-01
|
|
7914
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$104,991.14
|
$104,991.14
|
$104,991.14
|
2026-04-01
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
2
|
1
|
—
|
—
|
$103,288.48
|
$103,288.48
|
$103,288.48
|
2026-04-01
|
|
7934
|
APR_DRG
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
2
|
1
|
—
|
—
|
$81,329.84
|
$81,329.84
|
$81,329.84
|
2026-04-01
|
|
82
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
2
|
1
|
—
|
—
|
$85,549.30
|
$85,549.30
|
$85,549.30
|
2026-04-01
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
2
|
1
|
—
|
—
|
$102,248.33
|
$102,248.33
|
$102,248.33
|
2026-04-01
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
2
|
1
|
—
|
—
|
$162,380.56
|
$162,380.56
|
$162,380.56
|
2026-04-01
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
4
|
2
|
—
|
—
|
$38,441.80
|
$112,474.74
|
$75,458.27
|
2026-04-01
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
4
|
2
|
—
|
—
|
$131,311.37
|
$232,558.54
|
$181,934.96
|
2026-04-01
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
4
|
2
|
—
|
—
|
$297,603.27
|
$357,808.11
|
$327,705.69
|
2026-04-01
|
|
8423
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
4
|
2
|
—
|
—
|
$69,301.11
|
$74,572.16
|
$71,936.64
|
2026-04-01
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
4
|
2
|
—
|
—
|
$137,183.95
|
$180,826.26
|
$159,005.11
|
2026-04-01
|
|
8504
|
APR_DRG
|
Services
|
4
|
2
|
—
|
—
|
$121,127.25
|
$126,016.87
|
$123,572.06
|
2026-04-01
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
4
|
2
|
—
|
—
|
$65,934.12
|
$91,085.84
|
$78,509.98
|
2026-04-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
4
|
2
|
—
|
—
|
$84,158.72
|
$141,959.24
|
$113,058.98
|
2026-04-01
|
|
893
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
4
|
2
|
—
|
—
|
$60,510.42
|
$80,998.39
|
$70,754.40
|
2026-04-01
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
4
|
2
|
—
|
—
|
$108,293.01
|
$116,631.57
|
$112,462.29
|
2026-04-01
|
|
904
|
APR_DRG
|
Description Not Available
|
2
|
1
|
—
|
—
|
$178,361.21
|
$178,361.21
|
$178,361.21
|
2026-04-01
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
1
|
—
|
—
|
$85,876.39
|
$85,876.39
|
$85,876.39
|
2026-04-01
|
|
9103
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
4
|
2
|
—
|
—
|
$61,576.10
|
$83,547.51
|
$72,561.80
|
2026-04-01
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
4
|
2
|
—
|
—
|
$114,072.47
|
$140,216.94
|
$127,144.71
|
2026-04-01
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
4
|
2
|
—
|
—
|
$103,078.94
|
$132,469.27
|
$117,774.10
|
2026-04-01
|
|
9123
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
4
|
2
|
—
|
—
|
$62,503.61
|
$72,487.51
|
$67,495.56
|
2026-04-01
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
4
|
2
|
—
|
—
|
$120,331.56
|
$128,705.55
|
$124,518.55
|
2026-04-01
|
|
913
|
APR_DRG
|
Other Major Head And Neck Procedures
|
4
|
2
|
—
|
—
|
$58,518.82
|
$83,741.58
|
$71,130.20
|
2026-04-01
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
4
|
2
|
—
|
—
|
$65,794.36
|
$131,200.16
|
$98,497.26
|
2026-04-01
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
1
|
—
|
—
|
$104,640.45
|
$104,640.45
|
$104,640.45
|
2026-04-01
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
4
|
2
|
—
|
—
|
$103,792.20
|
$116,786.70
|
$110,289.45
|
2026-04-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
2
|
1
|
—
|
—
|
$165,124.77
|
$165,124.77
|
$165,124.77
|
2026-04-01
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
1
|
—
|
—
|
$143,468.22
|
$143,468.22
|
$143,468.22
|
2026-04-01
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
1
|
—
|
—
|
$311,282.83
|
$311,282.83
|
$311,282.83
|
2026-04-01
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
4
|
2
|
—
|
—
|
$115,482.40
|
$128,871.31
|
$122,176.85
|
2026-04-01
|
|
9514
|
APR_DRG
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
4
|
2
|
—
|
—
|
$85,832.78
|
$99,661.14
|
$92,746.96
|
2026-04-01
|
|
9524
|
APR_DRG
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
4
|
2
|
—
|
—
|
$73,795.87
|
$94,205.67
|
$84,000.77
|
2026-04-01
|
|
984
|
APR_DRG
|
Other Ear, Nose, Mouth And Throat Procedures
|
4
|
2
|
—
|
—
|
$66,092.94
|
$70,448.64
|
$68,270.79
|
2026-04-01
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
8
|
4
|
—
|
—
|
$61,627.62
|
$113,548.91
|
$87,506.26
|
2026-04-01
|
|
C9150
|
HCPCS
|
Xe129 Xenon, Diagnostic
|
2
|
1
|
—
|
—
|
$89,107.20
|
$89,107.20
|
$89,107.20
|
2026-04-01
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
2
|
1
|
—
|
—
|
$3,570,000.00
|
$3,570,000.00
|
$3,570,000.00
|
2026-04-01
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
2
|
1
|
—
|
—
|
$3,264,000.00
|
$3,264,000.00
|
$3,264,000.00
|
2026-04-01
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
2
|
1
|
—
|
—
|
$3,570,000.00
|
$3,570,000.00
|
$3,570,000.00
|
2026-04-01
|
|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
2
|
1
|
—
|
—
|
$4,335,000.00
|
$4,335,000.00
|
$4,335,000.00
|
2026-04-01
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
2
|
1
|
—
|
—
|
$2,244,000.00
|
$2,244,000.00
|
$2,244,000.00
|
2026-04-01
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
2
|
1
|
—
|
—
|
$2,856,000.00
|
$2,856,000.00
|
$2,856,000.00
|
2026-04-01
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
2
|
1
|
—
|
—
|
$3,162,000.00
|
$3,162,000.00
|
$3,162,000.00
|
2026-04-01
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
2
|
1
|
—
|
—
|
$2,146,250.00
|
$2,146,250.00
|
$2,146,250.00
|
2026-04-01
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
2
|
1
|
—
|
—
|
$201,669.02
|
$201,669.02
|
$201,669.02
|
2026-04-01
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
2
|
1
|
—
|
—
|
$265,000.00
|
$265,000.00
|
$265,000.00
|
2026-04-01
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
6
|
3
|
—
|
—
|
$31,905.54
|
$103,955.54
|
$79,539.70
|
2026-04-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
2
|
1
|
—
|
—
|
$532,192.24
|
$532,192.24
|
$532,192.24
|
2026-04-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
2
|
1
|
—
|
—
|
$566,531.30
|
$566,531.30
|
$566,531.30
|
2026-04-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$489,450.20
|
$489,450.20
|
$489,450.20
|
2026-04-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
2
|
1
|
—
|
—
|
$562,201.24
|
$562,201.24
|
$562,201.24
|
2026-04-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
2
|
1
|
—
|
—
|
$558,081.73
|
$558,081.73
|
$558,081.73
|
2026-04-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
2
|
1
|
—
|
—
|
$587,649.57
|
$587,649.57
|
$587,649.57
|
2026-04-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
2
|
1
|
—
|
—
|
$770,620.00
|
$770,620.00
|
$770,620.00
|
2026-04-01
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
2
|
1
|
—
|
—
|
$267,750.00
|
$267,750.00
|
$267,750.00
|
2026-04-01
|